Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $647.10 / $2,434.00 / $5,717.10	Facility		$647.10	$2,434.00	$5,717.10
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $63.61 / $617.00 / $2,059.05	Facility	52	$63.61	$617.00	$2,059.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.44 / $65.43 / $1,661.26	Facility	53	$25.44	$65.43	$1,661.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $220.75 / $496.20	Professional		$118.33	$220.75	$496.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.38 / $165.82 / $228.72	Professional		$100.38	$165.82	$228.72
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $712.58 / $712.58 / $712.58	Facility		$712.58	$712.58	$712.58
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,772.00 / $2,454.00 / $8,459.92	Facility		$1,772.00	$2,454.00	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $276.64 / $287.08 / $455.87	Professional		$276.64	$287.08	$455.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $320.00 / $719.77 / $1,418.21	Facility		$320.00	$719.77	$1,418.21
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.09 / $269.79 / $495.91	Professional		$133.09	$269.79	$495.91
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $268.70 / $268.70 / $268.70	Facility		$268.70	$268.70	$268.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $295.70 / $345.00 / $492.86	Professional		$295.70	$345.00	$492.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $821.20 / $1,841.40 / $3,352.79	Facility		$821.20	$1,841.40	$3,352.79
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $907.62 / $1,230.47 / $2,939.04	Facility	52	$907.62	$1,230.47	$2,939.04
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $2,127.67 / $2,127.67 / $4,182.18	Facility	53	$2,127.67	$2,127.67	$4,182.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.36 / $159.63 / $230.39	Professional		$141.36	$159.63	$230.39
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $712.58 / $712.58 / $712.58	Facility		$712.58	$712.58	$712.58
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $2,039.55 / $5,595.40	Facility		$400.00	$2,039.55	$5,595.40
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $163.58 / $830.63 / $2,059.05	Facility	52	$163.58	$830.63	$2,059.05
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $25.44 / $1,292.72 / $3,626.90	Facility	53	$25.44	$1,292.72	$3,626.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $119.81 / $260.10 / $647.75	Professional		$119.81	$260.10	$647.75
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,398.45 / $1,470.41 / $4,731.89	Facility		$1,398.45	$1,470.41	$4,731.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.13 / $377.20 / $691.20	Professional		$168.13	$377.20	$691.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $206.39 / $714.12 / $1,404.00	Facility		$206.39	$714.12	$1,404.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $134.57 / $274.04 / $495.91	Professional		$134.57	$274.04	$495.91
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $118.33 / $217.01 / $333.60	Facility		$118.33	$217.01	$333.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $274.07 / $300.20	Professional		$118.33	$274.07	$300.20
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,728.00 / $4,300.00	Facility		$550.00	$1,728.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $247.94 / $339.26 / $550.04	Professional		$247.94	$339.26	$550.04